Provider Demographics
NPI:1083033104
Name:SUPPORT FOR MOTHERS
Entity Type:Organization
Organization Name:SUPPORT FOR MOTHERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LACTATION CONSULTANT-IBCLC
Authorized Official - Prefix:
Authorized Official - First Name:NATHALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-214-0770
Mailing Address - Street 1:5313 BRIERCREST AVE
Mailing Address - Street 2:5313 BRIERCREST AVE
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90713-1423
Mailing Address - Country:US
Mailing Address - Phone:919-214-0770
Mailing Address - Fax:
Practice Address - Street 1:5313 BRIERCREST AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90713
Practice Address - Country:US
Practice Address - Phone:562-405-7500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-16
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL-45463174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty